NPIMap

Individual provider Active NPI

Scott R Ulmer, PA-C

  • Physician Assistant
  • Tyndall, SD
National Provider Identifier
1326697970
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1212 Issued in SD
Practice address
410 W 16TH Ave
Tyndall, SD 57066-2318
Phone
(605) 589-2100
Fax
(605) 589-2115
NPI assigned
Sep 6, 2019
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1212 SD Primary

Addresses

Primary practice location

410 W 16TH Ave
Tyndall, SD 57066-2318

Mailing address

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191022002361 SD Practitioner - Physician Assistant 4688906779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Michael's Hospital, Inc.Group PAC ID 2668380262, shared by 6 NPIs, 16 clinicians

Practice addresses (Care Compare)

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2158

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.34 of 100Reported as group
Quality
75.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1212SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Michael's Hospital, Inc. CurrentSince Sep 3, 2019 Accepting new patients
St Michael's Hospital, Inc. CurrentSince Dec 29, 2025 Accepting new patients

Locations

410 W 16th Ave
Tyndall, SD 57066
Phone (605) 589-2158

Interoperability endpoints

  • Direct secure messaging: scott.ulmer@avera.sdhealthlink.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1326697970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 16TH AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "570662318",
            "telephone_number": "605-589-2100",
            "fax_number": "605-589-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 16TH AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "570662318",
            "telephone_number": "605-589-2100",
            "fax_number": "605-589-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULMER",
        "first_name": "SCOTT",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-06",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyndall, SD

Sources for this page

Verify at the official NPI Registry.